HIPAA-compliant Form Builder

Design and Host Secure Online Web Forms

Request a demo

Enter your contact information

I accept LuxSci's privacy policy.

What is Form Builder?

A visual online web form builder and secure web form hosting solution.

Watch the video to learn.

HIPAA-compliant Form Builder

Most medical and health-based organizations require HIPAA-compliant forms to keep track of and transfer sensitive patient information. LuxSci's Secure Form Form Builder is a developmental tool that helps you organize, manage, and store all those forms in one place. The Secure Form FormBuilder provides easy Web form creation and secure hosting that's completely HIPAA- (Health Insurance Portability and Accountability) compliant. You can ensure the protection of your data during transmission because our hosted forms use encrypted text are accessible over TLS. FormBuilder also allows you to include custom CSS and Java Script to adjust the complexity of your security levels as needed.

Our form building and hosting services are ideal for contact, customer request, survey, and legal forms. Our forms are also responsive to mobile devices and designed to seamlessly collect digital signatures. You can start from scratch or with one of our templates as a guiding tool to create your form(s). All of our forms are also Wordpress-friendly and easy to update. Use LuxSci's Secure Form FormBuilder as a simple way to organize and automate your business. Secure Form FormBuilder provides the online security necessary for a safe and efficient practice.

FAQs: Perhaps you were wondering...?

Yes. FormBuilder is a WYSIWYG (what you see is what you get) editor with a tool bar that makes it simple for anyone to create basic or stunning Web forms. FormBuilder also includes templates you can use to get you going.

Yes. FormBuilder hosted forms are accessible over TLS, only.

Very. FormBuilder includes jQuery and allows you to include arbitrary JavaScript and CSS, permitting you to create very complex forms: for instance dynamic forms, use of third-party form widgets, custom validation, etc. FormBuilder even permits you to view and edit the HTML source code for your form.

Yes. You can embed your FormBuilder form in any existing website using an iframe.

Yes. You can either

  1. Upload to FormBuilder for secure hosting and inclusion in your form, or
  2. Link to images you have hosted elsewhere

At least without a lot of complex JavaScript work, you cannot:

  • Password-protect forms
  • Have multi-page forms that save the data of all pages and submit it as a single unit at the end, or that allow you to save and resume your work.

Yes. Amazon AWS Cloud hosts FormBuilder forms. They can scale to vast numbers of concurrent viewers and are safe from underlying server issues affecting uptime or performance.

You can copy and paste existing form content into FormBuilder, import existing images, and include your own JavaScript and CSS. However, FormBuilder is not a classical Web hosting space, so you can't upload an existing website or a directory of existing files.

FormBuilder is built into Secure Form, so the forms you design in FormBuilder are automatically configured to send data to Secure Form. You do not have to do anything in FormBuilder itself to connect it properly to Secure Form.

Other questions? Call Sales

FormBuilder Feature List

Building Forms

Visual HTML+Form Editor: No HTML Skills Needed
Add Ink Signatures

Form Builder includes a tool where you can insert and customize one or more Ink Signature boxes in your forms.

Form Save and Resume
Secure Form FormBuilder supports optional save and resume for long forms. The form saved form data is encrypted and temporarily stored in your database.

Save and Resume requires that users enter a password that will be used to access the saved form data (no "account" is created ... this password is used for authentication and encryption). The user is given a link that can be used, together with the password, to resume working on the form where they left off.

You can configured how long these saved form links are valid and how strong the user passwords must be. Non-HIPAA accounts (e.g. low security accounts) can also choose to forgo the need for a password.

Create Responsive Forms?
Drag-and-drop Form Creation
File Upload Input Fields?

Form builder allows you to add "File Upload" input fields to your form so that end users can submit files as well as other information.

Images Upload and Hosting

You can upload images for display in your web site form. These will also be securely hosted with your form.

Paste in an Existing Form?

If you have an existing form, you can copy and paste it into the Form Builder. The existing styles and look will be preserved as best as possible (all styles become inline styles on the elements).

Form Field Validation: Required Fields
Form Field Validation: Field Format

Form Builder can check text fields for valid:

  • Email address
  • Phone numbers
  • US Zip/Postal Codes
  • Credit Card Numbers
  • Web Site URLs
  • IP Addresses (v4)
  • US Social Security Numbers
  • Set a maximum length on the number of characters entered.
AJAX Submission detects offline state

Secure Form FormBuilder submits your forms* using AJAX. If the form submission fails due to lack of connectivity (e.g. the user or offline or the server is down/inaccessible), then the end user is notified with a little pop-up and can re-try the submission. The filled-in form is not lost.

* Does not apply to forms with file upload fields, as file upload is not currently supported over AJAX.

eBook: HIPAA-compliant Website Basics

Creating and managing HIPAA-compliant web sites

Book 2 in the LuxSci Internet Security Series.

Created by Erik Kangas, PhD

Get the HIPAA eBook

We use your High Volume SMTP service for our automated invoicing and purchase confirmations, so it is a critical part of our business. Your High Volume SMTP has been the most reliable we have used. The technical and sales support have been timely, efficient, and effective. I highly recommend."

Leonard S Rann . Tradavo